Abstract
Background: COVID-19, caused by severe acute respiratory syndrome (SARS), is known for high mortality rates across the
globe. Nonetheless, early diagnosis and treatment of this infectious disease are critical for increasing the recovery and survival of
patients. The present study aimed to investigate the causes of delays in referring to hospitals regarding COVID-19 deaths in the
first 48 hours of hospitalization to reduce mortality.
Methods: In this cross-sectional study, we extracted data from the families of 213 patients who died of COVID-19 between
February 2020 and February 2021 in Mashhad, Iran. The data were collected via phone using an 18-item checklist designed by
a panel of experts and related to the causes of hospitalization delays.
Results: Out of the 213 patients who died of COVID-19 in hospitals, 62.5% (133) were male, older (64 ± 12 years), illiterate (42%),
and with one or more comorbidities (92.4%). Regarding the effect of 10 delay causes in the checklist related to hospitalization,
it was reported that the highest score pertained to the fear of hospitalization (55.8%), following physicians’ advice about not
referring to hospitals (44.1%), and taking herbal medicines (32.3%), respectively.
Conclusion: Certain groups at higher risk of COVID-19 mortality included males, older individuals, and those with comorbidities.
Fear of hospitalization was the main reason for delays in referring to hospitals, suggesting the role of demographic characteristics,
socioeconomic status, and, most importantly, the role of social factors in increasing premature mortality